Sadok Boudaya

Ostéoarthropathie hypertrophique pneumique associée à la tuberculose pulmonaire

Hypertrophic osteoarthropathy is a syndrome frequently described in intrathoracic diseases, especially malignant ones. The association with lung tuberculosis is rarely reported. The authors describe the case of a 35-year-old patient, a smoker, hospitalised for lung cavitation associated with hypertrophic osteoarthropathy. The assessment of the aetiology was negative and the patient underwent lung surgery. The histopathological examination concluded as to chronic pulmonary tuberculosis. This report aims at alerting physicians about the possibility of hypertrophic osteoarthropathy in non malignant diseases, especially pulmonary tuberculosis which is still endemic in our country.

About thymic carcinomas: challenges in diagnosis and management.

Background Thymic carcinomas are rare tumors with a challenging diagnosis. Our aim was to report our 17-year experience of these tumors and to highlight the challenges encountered and the main differential diagnoses ruled out. Methods We studied 12 (92%) men and 1 (7.7%) woman with a mean age of 37 years (range 15–60 years). All patients were symptomatic, with chest pain representing the most frequent symptom. Radiology revealed anterior mediastinal masses in all cases, with either infiltration of the adjacent organs or pulmonary parenchymal metastases. Results The diagnosis was made on surgical biopsies in 12 cases and a lymph node biopsy in one. Microscopic examination revealed squamous carcinoma in 3 cases, synovial sarcoma in 1, mucinous adenocarcinoma in 1, undifferentiated carcinoma in 2, clear cell carcinoma in 1, lymphoepithelioma-like carcinoma in 2, atypical carcinoid tumor in 2, and sarcomatoid carcinoma in 1. Total surgical resection was possible in one patient after neoadjuvant chemotherapy and radiotherapy. Follow-up was possible in only 6 patients, and the mean survival reached 13 months. Conclusion In spite of the lack of follow-up information, this study demonstrates the poor outcome associated with these tumors and the need for standardized treatment.

Epithelioid Hemangioendothelioma of the Rib: A Rare Tumour with aConfusing Localization

Background: Epithelioid hemangioendothelioma is a rare tumour whose prognosis ranges from benign form similar to hemangioma to aggressive tumors like angiosarcoma. Its localization in the rib is very rare and less than 10 cases of costal localized forms have been reported in the literature. The authors describe another case of costal epithelioid hemangioendothelioma illustrated by microscopic findings. Case presentation: We present the case of a 80-year-old man who reported a pain in the shoulder. Radiologic findings showed a hypervascularized tumour and microscopic findings diagnosed an epithelioid hemangioendothelioma. The treatment was the en-bloc resection of second to fourth posterior left ribs and the wedge resection of the left lung nodule and the patient didn’t present complications after a 6-year- follow-up period. Conclusion: This case emphasizes on the challenging diagnosis of epithelioid hemangioendothelioma and the importance of surgical resection in localized forms.